{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:23:57Z","timestamp":1790900637448,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MY2\u2010155363"],"award-info":[{"award-number":["MY2\u2010155363"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess whether procedural\u2010induced abortion or provider\u2010initiated preterm delivery are associated with improved survival in pregnant people with cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Provinces of Alberta and Ontario, Canada, 2003\u20132016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Females aged 18\u201350\u2009years diagnosed with cancer at &lt;20\u2009weeks' (for the assessment of procedural\u2010induced abortion) or &lt;37\u2009weeks' gestation (for the assessment of provider\u2010initiated delivery).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cox proportional hazard models assessed all\u2010cause mortality in relation to procedural\u2010induced abortion and provider\u2010initiated preterm delivery, adjusting for cancer site, stage at diagnosis and age. Meta\u2010analysis pooled the results across both provinces.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>All cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 512 pregnant people diagnosed with cancer at &lt;20\u2009weeks' gestation and 782 diagnosed with cancer at &lt;37\u2009weeks' gestation. Neither procedural\u2010induced abortion (adjusted hazard ratio [aHR]\u2009=\u20091.39, 95% CI: 0.32\u20136.17) nor provider\u2010initiated preterm delivery (aHR\u2009=\u20091.17, 95% CI: 0.76\u20131.81) were associated with improved survival following adjustment for age, stage at diagnosis and cancer site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neither procedural\u2010induced abortion nor provider\u2010initiated preterm birth was associated with improved survival in pregnant people diagnosed with cancer; however, these obstetric interventions are highly personal decisions best decided by the pregnant person in consultation with their care providers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17937","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:33:49Z","timestamp":1724286829000},"page":"81-88","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Procedural abortion, provider\u2010initiated preterm delivery and survival in pregnant people with cancer: A population\u2010based cohort study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4449-9256","authenticated-orcid":false,"given":"Amy","family":"Metcalfe","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medicine, and Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe F.","family":"Cairncross","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel G.","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Toronto  Toronto Ontario Canada"},{"name":"SickKids Research Institute and IC\/ES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Shack","sequence":"additional","affiliation":[{"name":"Department of Oncology and Community Health Sciences University of Calgary  Calgary Alberta Canada"},{"name":"Cancer Research and Analytics, Cancer Care Alberta Alberta Health Services  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Friedenreich","sequence":"additional","affiliation":[{"name":"Department of Oncology and Community Health Sciences University of Calgary  Calgary Alberta Canada"},{"name":"Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta Alberta Health Services  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khokan","family":"Sikdar","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"},{"name":"Surveillance and Reporting Alberta Health Services  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarka","family":"Lisonkova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly A.","family":"McMorris","sequence":"additional","affiliation":[{"name":"Werklund School of Education University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parveen","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Cancer Control Research, BC Cancer  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deshayne B.","family":"Fell","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"},{"name":"IC\/ES  Toronto 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